Center for Anti-Infective Research & Development

About us

The mission of the Center for Anti-Infective Research & Development (CAIRD) is to advance anti-infective pharmacology and create optimal antibiotic utilization strategies that are safe and effective, while educating the clinical and scientific community for the purpose of benefiting the care of patients with infectious diseases both within and outside Hartford Healthcare.

CAIRD has been conducting research at Hartford Hospital since the late 1970’s. Their research portfolio ranges from pre-clinical, early discovery of new antibiotic molecules, to bench top microbiology and pharmacology, to clinical pharmacokinetics, and treatment outcome studies in patients admitted to Hartford Hospital.  Much of their research focuses around the development of new antibiotics for the treatment of multidrug resistant bacterial infections, an unmet medical need currently listed as one of the most important global threats by the World Health Organization (WHO).  This research, in collaboration with pharmaceutical or biotech companies, as well as academics worldwide, has led to the US approval of many antibiotics targeting multidrug resistant bacteria, such as ceftazidime/avibactam (Avycaz®), ceftolozane/tazobactam (Zerbaxa®), ceftaroline (Teflaro®), tigecycline (Tygacil®), and doripenem (Doribax®), among others.  Additionally, CAIRD also offers admitted patients opportunities to participate in a number of Phase 2 and Phase 3 clinical trials aimed to develop these new antibiotics.  These clinical study participation opportunities provide potential treatments for infections not otherwise treatable with currently available antibiotics and provide altruistic benefits that can aid patients worldwide once antibiotic development is completed.

In addition, CAIRD research has led to the implementation of clinical pathways, protocols, and guidelines at Hartford Hospital aimed to improve antibiotic use (i.e., Antimicrobial Stewardship), optimize patient outcomes, and reduce cost.  Examples of such interventions applied daily in the patient setting include:

  1. Once-daily, extended interval aminoglycoside dosing, which has been demonstrated to be a safer way to administer these antibiotics to patients (Nicolau DP et al, Antimicrob Agents Chemother 1995;39:650-5)
  2. Prolonged infusions of piperacillin/tazobactam, cefepime, and meropenem, which can reduce costs and improve treatment outcomes for critically ill patients
  3. The development of dosing regimens around stocking a single piperacillin/tazobactam vial, which will reduce drug waste and cost associated with stocking various vial strengths (Thabit AK et al. Presenting at IDWeek 2016, New Orleans, LA)
  4. The development and implementation of a ventilator-associated pneumonia protocol, which reduced infection related VAP mortality by 69% (Nicasio AM et al, J Crit Care 2010;25:69-77) and hospital costs for such patients by ~$20,000 per patient (Nicasio AM et al, Pharmacotherapy 2010;30:453-62)
  5. The development of a double carbapenem strategy for the treatment of carbapenem-resistant enterobacteriaceae (CRE) that has been applied worldwide in the absence of new drugs (Bulik CC et al Antimicrob Agents Chemother 2011;55:3002-4)
  6. The identification of a novel piperacillin/tazobactam resistance mechanism in Escherichia coli and Klebsiella pneumoniae that was not being recognized by the current microbiology cascading algorithm; CAIRD research led to a new microbiology protocol on reporting of resistant bacteria automatically to the provider (Thabit AK et al. Presenting at IDWeek 2016, New Orleans, LA).

Internal collaboration with other Hartford Hospital departments is a key to the success of these clinical interventions, and CAIRD has worked with the Infectious Diseases Division, Department of Microbiology, Department of Pulmonary Critical Care, Department of Surgical Critical Care, Podiatry, and Department of Pharmacy, among others, to improve the care of patients at Hartford Hospital who have infection.  Additionally, the results of these interventions have been published in peer reviewed journals so that other hospitals around the world can benefit from this knowledge.  As such these institutionally derived programs are commonly utilized in hospitals throughout the US in addition to many parts of the globe. Finally, CAIRD makes research antibiotic assays available for therapeutic drug monitoring free of charge to patients at Hartford Hospital as well as other investigators across the US. This has resulted in the optimization of antibiotic dosing in countless challenging cases both here at Hartford (Kuti JL et al. Pharmacotherapy 2004;24:1641-5, Kuti JL et al. Int J Antimicrob Agents 2016;48:342-3) and at other medical centers (Children’s Hospital of Michigan, Detroit, MI, Ang JY et al. Antimicrob Agents Chemother 2016;60:5627-30; Edward Hines, Jr. VA Medical Center, Hines, IL, Patel UC et al. Infect Dis Ther 2016;5:73-9; MD Anderson Cancer Center, Houston, Texas, Aitken et al Ped Infect Dis J 2016;35:1040-1042; Maine Medical Center, Portland, ME, Balwan et al Antimicrob Agents and Chemother 2016;60(1):1-5).

Click on the names below to view a full list of that author's publications:

David P. Nicolau, PharmD, FCCP, FIDSA
Joseph L. Kuti, PharmD, FIDP
Kamilia Abdelraouf, PhD
Tomefa Asempa, PharmD

CAIRD productivity can be measured not only in the numerous national and international presentations at scientific meetings and peer-reviewed publications, which averages 20-30 per year with a peak of more than 50 in FY2016, but also in research funding that is sufficient to fully support a staff of 25 without any additional operational monies from the institution.

Research